Trial of Tramadol Plus Gabapentin for Opioid Detoxification

Abstract

Background:Substance abuse or drug addiction is one of the most important health issues in every society, which can lead to physical and mental problems.Objectives:This study aimed to compare the efficacy of tramadol plus gabapentin versus methadone use in the treatment of opiate withdrawal.Patients and Methods:Consenting male subjects who fulfilled the DSM-4 criteria for opiate dependence syndrome (opium, residue, and heroin) were randomly assigned in two groups to receive tramadol plus gabapentin or methadone. Assessment tools were Adjective Rating Scale for Withdrawal (ARSW), Clinical Opiate Withdrawal Scale (COWS) and Visual Analogue craving Scale (VAS). Fifty-nine subjects were enrolled and evaluated on days 1, 2, 3, 4, 6, and 8 during their 10 days of admission. Twenty-nine participants received methadone and the other 30 received tramadol plus gabapentin for their treatment.Results:Mean (SD) age of the patients in methadone group and tramadol plus gabapentin group were 33.9 (7.1) and 32.4. (8.1), respectively (P = 0.462). The overall ARSW (P value = 0.263) and COWS (P = 0.862) scores between the two groups were comparable. The differences in the VAS score for craving between the two groups was marginally significant (P = 0.057). The highest VAS score was at the third day of admission in both groups and it was generally higher in methadone group.Conclusions:The severity of withdrawal syndrome in two groups was not significantly different. The craving was higher in the group receiving methadone from the second day of admission even though the usage amount was higher in the tramadol plus gabapentin group. The findings of this study suggest that the combination of tramadol plus gabapentin is an efficient method for opioid detoxification.

A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency’s ‘Suspected Adverse Drug Reactions’ Database

“…Gabapentin is approved to treat epilepsy and neuropathic pain disorders [4,34], with off-label use of the molecule including restless legs syndrome, migraine, vasomotor symptoms of menopause, and alcohol and substance dependence [2,[35][36][37][38]. There are anecdotal reports of its misuse [39], particularly in cocaine users and prison settings [40,41].…”

Role of oral tramadol 50 mg in reducing pain associated with outpatient hysteroscopy: A randomised double‐blind placebo‐controlled trial

“…It is an atypical analgesic with a dual mechanism of action: serotonin and norepinephrine reuptake inhibition and modest μ ‐opioid agonist. It has a lower incidence of respiratory depression, cardiac depression, side effects on smooth muscle and abuse potential as compared to typical opioid agents . Intravenous and intramuscular tramadol given before hysteroscopy were shown to reduce pain associated with hysteroscopy, but no data were available on the effectiveness of oral tramadol …”

Use of Gabapentin in the Treatment of Substance Use and Psychiatric Disorders: A Systematic Review

“…GBP enhances GABAergic activity or modulates the release of excitatory neurotransmitters because of its GABAergic properties (66). Our literature search found 6 RCTs, which studied the efficacy of GBP as an agent in opiate detoxification (66–71) ( Table 2 ). GBP was found either alone or adjunctively to be significantly effective in achieving favorable changes in opiate detoxification symptoms and in reducing opioid consumption, e.g., Moghadam and Alavinia (69), Ziaaddini et al (71), and Sanders et al (70).…”